Alcohol is one of the most commonly used and misused substances in America. An estimated 15.1 million adults live with alcohol use disorder, and 88,000 alcohol-related deaths occur every year, making alcohol the third most common cause of preventable death. However, alcohol detox and withdrawal symptoms are profoundly uncomfortable and often dangerous. Extreme cases of withdrawal can be lethal. For these reasons, it is recommended that detox and acute withdrawal be done under medical supervision. In some cases, pharmacological interventions can be used to help mitigate the severity of symptoms.
Alcohol Withdrawal Symptoms
Alcohol withdrawal syndrome symptoms are generally predictable and begin around six hours following the last drink. Symptom severity peaks between 24 hours and 72 hours, and generally subside within seven days. Mild alcohol withdrawal symptoms often include tremors, anxiety, insomnia, restlessness, and nausea. People with mild to moderate alcohol addiction often do not experience more severe symptoms, but people with chronic alcohol use disorder begin to experience symptoms such as low-grade fever, rapid breathing, pronounced tremors, profuse sweating, vomiting and diarrhea around 24 hours after the last drink. In the most serious cases of alcohol use disorder withdrawal, seizures, delirium tremens and heart attack may occur. These are life-threatening symptoms, with mortality rates as high as 4% for people who are in a hospital or rehab program and nearly 37% for people who are left untreated.
Even mild to moderate alcohol use disorder withdrawal symptoms can be incredibly uncomfortable and frequently debilitating. Medical complications may arise that are associated with serious adverse effects. For these reasons, it is recommended that an evaluation be done with a medical professional before detox.
How to Manage Alcohol Withdrawal Symptoms at Home
The odds of successfully managing alcohol withdrawal symptoms at home may be good for someone with mild alcohol use disorder, but even mild to moderate alcohol withdrawal should be done at home only after consulting with a medical professional. It’s always safest to undergo alcohol withdrawal under the care of a trained medical professional in a supervised, clinical setting.
Dangers of Alcohol Withdrawal at Home
Alcohol use disorder causes very real changes in the brain, particularly to levels of the neurotransmitter GABA and receptors for the neurotransmitter NMDA. Under normal circumstances, GABA prevents the brain from becoming overexcited. Alcohol causes increased levels of GABA, which the brain attempts to counteract by reducing the number of GABA receptors. Alcohol also prevents the excitatory neurotransmitter NMDA from being able to interact with its receptor to activate cells in the brain. The net consequence of these alcohol-induced changes is an overall reduction of brain activity that persists for as long as alcohol continues to be consumed.
The dangers of detox stem from these chemical imbalances: Sudden cessation of alcohol use results in a rapid decrease in the brain’s ability to regulate inhibition (loss of GABA in conjunction with abnormally low numbers of GABA receptors) and excitation (increased availability of NMDA receptors potentiates cell activity). These neurobiological events underlie mild and moderate withdrawal symptoms including tremors, anxiety, insomnia, profuse sweating and hyperthermia, which are all consequences of brain hyperexcitation. In severe cases, this rapid increase in brain excitability can cause potentially lethal seizures, delirium tremens and heart attack.
Even mild alcohol detox and withdrawal are associated with a risk of medical complications. It is always recommended that you consult with a medical professional before you start the detox process and undergo withdrawal symptoms in a clinically supervised environment.
Delirium tremens is a severe symptom of AUD withdrawal, and affects 3–5% of people experience alcohol withdrawal symptoms. Delirium tremens symptoms include the standard physical symptoms of severe withdrawal (tremors, sweating, anxiety, nausea and vomiting) as well as global confusion, delirium, hallucinations, nightmares and disturbances in attention and awareness. These symptoms typically appear about three days after the onset of withdrawal and usually persist for 2–3 days, although in some cases they may last for up to a week.
Home Detox Relapse Rates
Relapse rates associated with home detox are somewhat difficult to get accurate statistics on, but an estimated 50–80% of people who detox without any form of treatment will relapse within a year. This data underscores the incredible value of rehab programs in alcohol use disorder recovery.
Alternatives to Alcohol Withdrawal at Home
Recovering from alcohol use disorder is challenging, especially if you do it alone. Treatment programs have been repeatedly shown to make the detox and acute withdrawal phase more comfortable and significantly increase the odds of successfully maintaining short and long-term sobriety. Among the alternatives to home detox are:
- Inpatient Alcohol Detox: For many people, inpatient detox is the first step towards recovery. Inpatient care includes medical detoxification and full-time supervision of acute symptoms, as well as 24-hour access to medical professionals who can address questions or concerns as they arise.
- Hospital-Based Detox: Hospital-based detox programs are less intensive than inpatient programs. These programs are short-term and provide full-time medical supervision and therapy sessions that are designed to prepare the client for reintegration into the community. Some programs require that the client live on-site, while other programs do not.
- Residential Rehab: Residential programs typically involve long-term care that follows the acute detox and withdrawal process. Residential care offers around-the-clock access to rehab professionals and typically includes individual and group therapy. The goal of residential rehab is to provide clients with a safe, secure place where they can reorient to a sober lifestyle.
If you or someone you love is struggling with alcohol use disorder, The Recovery Village Palm Beach at Baptist Health can help. We offer comprehensive inpatient, residential and outpatient rehab programs that are tailored to suit your needs. Call The Recovery Village Palm Beach at Baptist Health today to begin your path to recovery.
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Rahman, Abdul; Paul, Manju. “Delirium Tremens (DT).” NCBI StatPearls, updated November 2018. Accessed August 18, 2019.
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Moos, Rudolf H; Moos, Bernice S. “Rates and predictors of relapse after natural and treated remission from alcohol use disorders.” Addiction, February 2006. Accessed August 18, 2019.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.